We were able to reduce our son's frequent and serious histamine and mast cell reactions, by working with the body's natural functions. The body excretes histamine in similar ways as other chemicals, so there are ways to help a functional bottleneck and support the boty's natural function. Decreasing dietary histamine, supporting liver function, controlling the triggers that you know about can help dramatically.

1. Methods we used to lower our young son’s histamine burden,
to reduce the frequency and intensity of dangerous and painful
histamine mediated reactions.
Copyright Tiffany Blackden 2013
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The Mastocytosis Society
DC Regional Regional Meeting
April 2013

2. Copyright Tiffany Blackden 2013
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Our family!
The reasons we’ve stayed up all night
researching and continuing to figure
out ways to support health!

3. Mast Cell Activation Syndrome
I.Systemic
Anaphylaxis
Faintness
Fatigue
II.Dermatologic
Flushing
Rashes
Itching
Hives
III.Cardiovascular
Blood pressure changes
and shock
Chest pain
Rapid heart rate
IV.Pulmonary
Wheezing
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4. V.Musculoskeletal
Bone pain
Muscle pain
Degenerative disc disease
Osteoporosis/osteopenia
VI.Gastrointestinal
Nausea
Vomiting
Abdominal pain
Gastroesophageal reflux
Diarrhea
Inflammation of the
esophagus
Intestinal cramping and
bloating
Malabsorption
VII.Neurologic
Cognitive
difficulties/brain fog
Dizziness/vertigo
Lightheadedness
Migraine headache
Paresthesia
Peripheral neuropathy
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5. Max’s Daily MCAS Presentation
Hives, dermatographia, flushing, swelling, stomachaches,
headaches, fatigue, stuffiness, dizziness, reflux, diarrhea,
leg pain, itching from:
Foods (too many to name!)
Friction
Heat
Cold
Change in temp
Animals
Chemicals
Synthetic Fabrics
Skin Contact With Plants/Grass
Etc…???
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6. A few of his
reactions:
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Blisters on both lower legs
after consuming olive oil.
Rolled around on
synthetic rug…taken
after the hives calmed
down a bit.
Really angry reaction
from playing with a
scratchy rope. This was
after it was calm, we
nearly went to the
hospital, it covered
much of his torso and
his left arm.

7. Max’s Health Team:
Naturopathic Doctors
Nationally Certified Nutritionists
Acupuncturist - BioSet Practitioner
Chinese Medicine Practitioner
Osteopathic Doctor (D.O.)
Chiropractor
MD Homeopath
Biomedical MD
His Mommy, Daddy and Sister
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8. What’s in a mast cell?
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Today we are focusing on HISTAMINE…
Art by: Angela Canada Hopkins
http://www.canadahopkins.com/
Over 100 different molecules that
protect the body, as well as causing
inflammation.
Preformed mediators :
(from granules)
-Serine proteases
-Tryptase
-Histamine
-Serotonin
-Proteoglycans-mainly heparin
Newly formed Lipid Mediators:
(eicosanoids)
-Thromboxane
-Prostoglandins
-Leukotreines
-Platelet Activating Factor
-Cytokines

9. The reasons we focused on lowering
the systemic histamine burden:
First step in protocol for mast cell disorders is
antihistamines, primarily H1 and H2 drugs.
Mast cells have histamine receptors on the cell
membrance that make them more ready to
degranulate or selectively secrete mediators.
Dietary histamine (and other biogenic amines, like
tyramine) was a primary *group* of foods that were
bothering our son.
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10. Copyright Tiffany Blackden 2013
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Local Immune Response for Injury
Protective Mechanism in ‘Boundary’ Tissues
Regulates Smooth Muscle Contraction
Neurotransmitter

11. Histamine Affects
Every System of the Body
Neurological
Cardiovascular
Musculoskeletal
Gastrointestinal
Reproductive
Respiratory
Cutaneous
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It is produced in mast cells, basophils, platelets, neutrophils and some
neurons…and stored intracellularly, then released when stimulated.

12. Histamine Receptors:
H1: Smooth Muscle, Endothelium, Central Nervous
System Tissue, Mast Cells
H2: Gastrointestinal, Vascular Smooth Muscle Tissue,
Mast Cells
H3: Central Nervous System and Some Peripheral
Nervous System, Mast Cells
H4 (Just discovered in 2000): Bone Marrow, Basophils,
Thymus, Small Intestine, Spleen, Colon, Mast Cells
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13. Copyright Tiffany Blackden 2013
All Rights Reserved Dtsch Arztebl 2006; 103(51–52):A 3477–83.

14. Sources of Histamine:
Normal Metabolic Function Throughout Body
Dietary Histamine
Foods That Release Histamine From Mast Cells
IgE (Allergy) Mast Cell Degranulation
 Non-IgE (Trigger)Mast Cell Degranulation
Bacteria
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15. Histamine Burden is cumulative
over the course of a day
(sometimes persisting beyond a
day, if the burden is high).
Control what you CAN, to keep
the cup from overflowing with all
the factors *not* in your control.
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16. Histamine Overload…
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Histamine for Digestion (histamine
secreted to release stomach acid in
normal digestion)
Pineapple (contains histamine AND
can release histamine directly from
cells)
Sodium Benzoate in Soda (common
food/beverage preservative and mc
degranulator)
Cat Dander (IgE)
Ragweed (IgE)
Hot Day/Pressure/Friction/ Vibration
(all physical mast cell triggers)
Chicken Leftover in Fridge
(histamine produced by
proteins breaking down)
Combination of IgE, endogenous (made inside the body), naturally occurring dietary
histamine, physical triggers, and consumption of histamine releasing substances.

17. Avoiding High Histamine Pitfalls…
All of these can increase your histamine burden, or
decrease your body’s ability to process histamine.
Fermented Foods
Cured Foods
Dyes
Preservatives/Additives
Sulphites
Refrigerated Leftovers (we freeze them)
Alcohol
High Histamine Foods
Histamine Releasing Foods
Histamine Degrading Enzyme Inhibiting Chemicals
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18. Some Histamine Liberating or DAO/HMT Inhibiting Meds
Substance class Some Active agents
 Radiological Contrast media
 Muscle relaxants Pancuronium, Alcuronium, D-Tubocurarin
 Narcotics Thiopental
 Analgesics Morphine, pethidine, NSAR, ASS, metamizole
 Local anesthetics Prilocaine
 Antihistamines Dyphenhydramine
 Antihypotensives Dobutamine
 Antihypertensives Verapamil, alprenolol, dihydralazine
 Antiarrhythmics Propafenon
 Diuretics Amiloride
 Motility agents Metoclopramide
 Antibiotics Cefuroxime, cefotiam, isoniazid,pentamidine,
clavulanic acid, chloroquine
 Mucolytics Acetylcysteine, ambroxol
 Broncholytics Aminophylline
 H2 receptor antagonists Cimetidine
 Cytostatics Cyclophosphamide
 Antidepressants Amitriptylline Copyright Tiffany Blackden 2013
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19. Now we know how we get
histamine IN our systems…
How Does Histamine
*EXIT* Our Bodies?
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20. Deactivation AND Liver Metabolism
Enzymes that BREAK DOWN Histamine:
o DAO (Diamine Oxidase)
o HMT/HNMT (Histamine Methyltransferase)
o MAO A (Monoamine Oxidase A)
Phase I & II Liver Detoxification
o Methylation
o Sulfation
o Oxidation
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21. Functional Bottleneck: What other molecules use the *same exit
pathways* as histamine (and other inflammatory mediators)?
Medications
Pesticides
Herbicides
Hormones
Bacteria
Antibodies
Neurotransmitters
Chemical Fragrances
Inhaled Chemicals
Chemicals in Municipal Water
Preservatives in Food and Body Products
Additives in Food and Body Products
Dyes
More…
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22. Ways to Help the Liver Flush Histamine
Reduce overall chemical load.
Move lymph in our bodies.
Exercise.
Lower our stress level.
Drink lots of clean water.
Get adequate nutrients for detoxification.
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23. REDUCING OVERALL CHEMICAL LOAD-
Indirect Contact
Yard
Insect Repellants, Weed Killers, Fertilizers
Home
 Cleaning, Air freshening, Painting, Construction, Pet products
Public Places
stores with fragrance everywhere, airborne chemicals from
products in stores, people with perfume/detergent/dryer sheet
Hobby
Paints, Compounds, Gasoline, Carbon Monoxide, Polishes,
Cleaning Products
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24. REDUCING OVERALL CHEMICAL LOAD –
Direct Contact
Body
Soaps, Shampoo/Conditioner, Lotions,
Hair Sprays, Nail Products, Toothpaste
Deodorant
Clothes with chemicals from
detergents/dryer sheets
Food
Additives, Preservatives, Sweeteners,
Pesticides, Herbicides, Plastics,
Chemicals from municipal water
(Chlorine, Fluoride, Aluminum,
Antibiotics, Hormones, etc)
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California Baby
Bubble Bath
Mast Cell
Degranulating
Preservative

25. Some doctors in Europe treat histamine intolerance as a progressing
disease process…histamine has role in chemotaxis (programmed cell
death), so could an enzyme deficiency or chronic, systemic build up of
histamine be related to mast cell proliferation (mastocytosis)?
Mastocytosis
MCAD
Hypersensitivity Disorder
Histaminosis
Histamine Intolerance
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26. Mast Cell – Histamine Diaries
Foods (Sensitivities/Histamine/Glycemic Index)
Beverages (Hydration Level/Dyes/Sweeteners)
Exposures (Pollen/Stores/Chemicals/Smells)
Reactions (Type/Duration/Medication)
Sleep (Amount/Quality)
Emotional State (Anxious/Depressed/Happy/Stressed)
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27. Our Daily High Quality Nutrition
Drink plenty of good quality water EVERY day.
 Low Histamine/Tyramine/Other Biogenic Amines, Organic Whole Foods
(locally grown when possible)
 Rotate Foods As Much As Possible
 No Gluten/Dairy/Soy/Eggs/Nuts/Citrus/Dyes/Additives
Preservatives/Polyunsaturated Fats
 Only grass fed beef, venison and wild caught fish
 Good quality fats daily(No PUFAs, we use ghee and coconut oil)
 Digestive Enzymes
 Sources of Trace Minerals (Pink Himalayan Salt, Dulse Flakes & Wakame,
Superdupermineralpackedwheatgrass juice)
 Some High Quality Supplements (Vit D, Vit K2, Mitochondrial Support
Supps-CoQ10, l-carnitine, d-ribose and magnesium)
 Raw Leafy Greens (methylation support)
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28. Other Daily Health Support
Hydration, Hydration, Hydration
Dense Nutrition
Epsom Salt Baths Almost Daily (Additional Magnesium
Chloride Spray as Needed)
Moderate Exercise-Play, Mini Trampoline
Clean Air
Good Quality Sleep
Limit All Man-made Chemical Exposure Possible
Ayurvedic-Style Meal Preparation (60%+ of calories by 1pm)
12 Hour Night Fast (Liver Function Support)
Low Stress
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29. Locally grown, organic when possible:
Helps us avoid GMOs, Herbicides, Pesticides
This food has more micronutrients, more live enzymes,
was JUST harvested (not weeks ago, ripening on a truck)
and hasn’t been sprayed with a preservative at a grocery
store(which is derived from GMO corn).
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30. What MCAS has taught us:
 WE are responsible for our family’s healthcare…it is necessary to understand as much as
we can, so we can make the lifestyle changes necessary for health.
 We *hire* doctors, and can choose the team that serves us best. We require that they
are open minded and willing to do some research, since this disease is such an
unknown. Much of our most effective care has been out of pocket and on the periphery
of traditional western medicine.
 Stress has a dramatic effect on our health. This can NOT be overstated, when mast cells
and histamine levels are involved.
 Eating right and living in a way that has allowed a healthier life was not easy (we moved
across country, let our beloved pets go, change our diet, change all of our household and
personal care products and homeschool to help our son), but every step we’ve taken has
brought us to a more complete level of health and wellness.
 It’s a marathon, that requires daily effort. It can’t be done as a sprint…little changes,
consistently added, allow for some sense of balance as you go along the path.
 When you have a chronically sick child, it is vitally important to take care of yourself.
 We must trust our intuition.
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31. Get in touch, get support…
Please connect with me:
Tiffany Blackden on Facebook, Twitter or LinkedIn
Email: Tiffany@TiffanyBlackden.com
Join Facebook Group:
“Mastocytosis – Holistic Approach”
Our FB page for our medical journey & research:
www.Facebook.com/blackdenfamily
Copyright Tiffany Blackden 2013 All Rights Reserved